New-Onset Atrial Fibrillation and Adverse In-Hospital Outcome in Patients with Acute Pulmonary Embolism.

Atrial fibrillation (AF) can be secondary to acute pulmonary embolism (PE). This study aimed to investigate the prognostic impact of new-onset AF on patients with acute PE. In this study, 4,288 consecutive patients who were diagnosed with acute PE were retrospectively screened. In total, 77 patients with acute PE and new-onset AF were analyzed. Another 154 acute PE patients without AF were selected as the age- and sex-matched control group. Adverse in-hospital outcome comprised one of the following conditions: all-cause death, endotracheal intubation, cardiopulmonary resuscitation, and intravenous catecholamine therapy. The patients with new-onset AF had higher prevalence of congestive heart failure, higher simplified PE severity index (sPESI), higher creatinine, and larger left atrium diameter. The incidences of adverse in-hospital outcomes were 10.4 and 2.6% in patients with new-onset AF and no AF, respectively (p = 0.02). Patients with sPESI ≥ 1 had higher incidence of adverse in-hospital outcomes than those with sPESI = 0 (9.4 vs. 0.9%, p < 0.01). The area under the receiver operating characteristic curve of sPESI and sPESI + AF (adding 1 point for new-onset AF) scores in assessing the adverse in-hospital outcome were 0.80 (95% confidence interval [CI]: 0.68-0.93) and 0.84 (95% CI: 0.72-0.96), respectively. In multivariable analysis, sPESI ≥ 1 (odds ratio, 8.88; 95% CI: 1.10-72.07; p = 0.04) was an independent predictor of adverse in-hospital outcome. However, new-onset AF was not an independent predictor. In the population studied, sPESI is an independent predictor of adverse in-hospital outcomes, whereas new-onset AF following acute PE is not, but it may add predictive value to sPESI.

Vagal baroreflex activation resulting in acute coronary stent thrombus associated with myocardial infarction: a case report.

BACKGROUND: Percutaneous coronary intervention with stenting in patients with coronary atheromatous stenosis carry an inherent risk of affecting the baroreflex-mediated regulation of hemodynamic alterations, especially for heart rate and blood pressure. To the best of our knowledge, the vagal baroreflex activation associated with acute coronary stent thrombosis in patients who have undergone percutaneous coronary intervention has not been previously reported. CASE PRESENTATION: In the present article, we report a case of a Chinese patient (a 75-year-old male) with coronary artery disease who presented with hemodynamic alterations as a complication of vagal baroreflex activation after implantation of overlapping stents, followed by stent thrombosis associated with myocardial infarction. CONCLUSION: The patient's vagal baroreflex sensitivity increased after the coronary stenting procedure. He was successfully treated with intra-aortic balloon pump therapy. Because of its rarity, this case is being reported to emphasize the importance of using intra-aortic balloon pump therapy.

A Waterborne Gastroenteritis Outbreak Caused by Norovirus GII.17 in a Hotel, Hebei, China, December 2014.

Norovirus (NoV) is responsible for an estimated 90 % of all epidemic nonbacterial outbreaks of gastroenteritis worldwide. Waterborne outbreaks of NoV are commonly reported. A novel GII.17 NoV strain emerged as a major cause of gastroenteritis outbreaks in China during the winter of 2014/2015. During this time, an outbreak of gastroenteritis occurred at a hotel in a ski park in Hebei Province, China. Epidemiological investigations indicated that one water well, which had only recently been in use, was the probable source. GII.17 NoV was detected by real-time reverse-transcription polymerase chain reaction from samples taken from cases, from concentrated water samples from water well, and from the nearby sewage settling tank. Nucleotide sequences of NoV extracted from clinical and water specimens were genetically identical and had 99 % homology with Beijing/CHN/2015. All epidemiological data indicated that GII.17 NoV was responsible for this outbreak. This is the first reported laboratory-confirmed waterborne outbreak caused by GII.17 NoV genotype in China. Strengthening management of well drinking water and systematica monitoring of NoV is essential for preventing future outbreaks.

Serum endocan levels are correlated with the presence and severity of coronary artery disease in patients with hypertension.

BACKGROUND: Endothelial dysfunction is one of the most important early indicators of atherosclerosis in hypertension (HT) patients. Endocan has been reported to play a role in the pathophysiology of endothelial dysfunction. OBJECTIVE: We sought to assess whether serum endocan levels are correlated with the presence and severity of coronary artery disease (CAD) in patients with HT. METHODS: We measured endocan levels in 164 patients with HT and in 55 controls. The severity of CAD was assessed by the coronary atherosclerosis index scores. RESULTS: Serum endocan levels were independently correlated with the presence and severity of CAD in HT patients. CONCLUSION: Endocan might function as a useful biomarker for monitoring the development and progression of CAD in HT patients.